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TRICARE Policy Manual 6010.60-M, April 1, 2015
Medicine
Chapter 7
Section 23.1
Augmentative Communication Devices (ACDs)
Issue Date:  December 8, 2004
Authority:  32 CFR 199.4(e)(23) and 10 USC 1077(e)(1)
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-1, March 10, 2017
1.0  CPT PROCEDURE CODES
92605, 92607, 92608, 97755, 97608
2.0  HCPCS PROCEDURE CODES
E2500 - E2599, and V5336
3.0  POLICY
3.1  ACDs (also referred to as Speech Generating Devices (SGDs) and medically necessary services and supplies that provide an individual who has a severe speech impairment with the ability to meet functional speaking needs are covered. ACDs/SGDs are characterized by:
3.1.1  Being a dedicated speech device, used solely by the individual who has severe speech impairment;
3.1.2  May have digitized speech output, using pre-recorded messages, less than or equal to eight minutes recording time;
3.1.3  May have digitized speech output, using pre-recorded messages, greater than eight minutes recording time;
3.1.4  May have synthesized speech output, which requires message formulation by spelling and device access by physical contact with the device-direct selection techniques;
3.1.5  May have synthesized speech output, which permits multiple methods of message formulation and multiple methods of device access; or
3.1.6  May be software that allows a laptop computer, desktop computer or personal digital assistant (PDA) to function as a speech generating device.
3.2  ACDs and SGDs as defined in 32 CFR 199.2 are considered voice prostheses. The prosthesis provisions found at Chapter 8, Section 4.1 apply.
4.0  EXCLUSIONS
Examples of devices that do not meet the above definition and are excluded from coverage as ACDs/SGDs include, but are not limited to:
4.1  Devices that are not dedicated speech devices, but are devices that are capable of running software for purposes other than for speech generation, e.g., devices that can also run a word processing package, an accounting program, or perform other non-medical functions.
4.2  Laptop computers, desktop computers, or Personal Digital Assistants (PDAs), which may be programmed to perform the same function as a speech generating device, are non-covered since they are not primarily medical in nature and do not meet the definition of prosthetic, prosthetic device, prosthetic supply, or Durable Equipment (DE).
4.3  Communication aids that do not generate speech are not covered. Communication aids that are not ACDs/SGDs are not considered prosthetics for speech. Examples of noncovered communication aids include the following: picture books; flashcards; Braille typewriters; Teletypewriter (TTY) devices; devices that allow the patient to communicate messages to others with writing (e.g., a display screen or printout) rather than with synthesized speech; and devices that allow the user to communicate with a computer rather than with another person. Although these devices may be useful, they do not meet the definition of an ACD/SGD, prosthetic, or DE.
4.4  Altered auditory feedback devices are communication aids that are excluded because they are not augmentative communication devices/voice prostheses.
5.0  EXCEPTION
Computer based and PDA based ACDs/SGDs are covered when they have been modified to run only ACD/SGD software.
6.0  EFFECTIVE DATE
September 1, 2005.
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